Happy Hypoxia in COVID-19 Patients at Kinshasa University Hospital (Democratic Republic of the Congo): Frequency and Vital Outcome

Jonathan Mutombo Muamba ,Tresor Pata ,Felly Tshikangu,Bertin Nsitwayizatadi,Ossam Odio,Jean Marie Kayembe,Godelive Nsangana,Marcel Mbula,Murielle Longokolo,Serge Nkarnkwin,Hervé Mole,Guyguy Kamwiziku,Gabriel Makeya ,Patricia Kabuni,Kazadi Mutombo,Aliocha Nkodila,Eric Mukenge ,Ben Bepouka ,Rodrigue Ngwizani,Yamin Kokusa,Yves Yanga,Gorby Ndaie,Nadine Mayasi,Dupont Maheshe,Christine Namasale,Hippolyte Situakibanza,J.r. Makulo ,Roger Kabango ,Hervé Keke,Jean Claude Makangara,Madone Mandina,Nice Musangu,Tharcisse Mabiala,Patrick Mukuna ,Papy Tshimanga,Donatien Mangala,Gabriel K. Mbunsu

doi:10.4236/jbm.2021.92002

Abstract

Background: Happy hypoxia is a new feature found in COVID-19 patients. It consists of the presence of severe hypoxemia but normal breathing rate. Failure to identify this hypoxia may have negative consequences on the survival of the patient. The objective of the present study was to measure the frequency of patients with happy hypoxia and to evaluate their survival at the Kinshasa University Hospital (KUH). Methods: This was a historical cohort of 141 hospitalized patients with COVID-19 at KUH from March 23 to June 15, 2020. Happy hypoxia was defined as oxygen saturation below 90% without dyspnea. Socio-demographic data, co-morbidities, follow up time of hospitalization and outcomes were studied. Survival was assessed using the Kaplan Meier curve. Results: Out of 141 hospitalized patients with COVID-19, 79 (56%) patients were at the severe or critical stage and 9 (6.4%) had a happy hypoxia on admission. Patients who had happy hypoxia on admission were generally older than 60 years of age (55.6%) (p = 0.023). Comparison of survival curves, based on the presence or absence of happy hypoxia, shows a statistically significant difference (p = 0.001). The presence of happy hypoxia reduces survival. Conclusion: The frequency of happy hypoxia among COVID-19 patients was low. Survival was reduced in patients with happy hypoxia. Prehospital pulse oximetry could serve as an early warning signal for the detection of happy hypoxemia in COVID-19 patients.

Highlights

The world is facing a severe pandemic called Coronavirus 2019 Disease (COVID-19) caused by the new Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2), which broke out in China in December 2019
Survival was reduced in patients with happy hypoxia
Prehospital pulse oximetry could serve as an early warning signal for the detection of happy hypoxemia in COVID-19 patients

Summary

Introduction

The world is facing a severe pandemic called Coronavirus 2019 Disease (COVID-19) caused by the new Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2), which broke out in China in December 2019. Patients with severe disease may develop acute respiratory distress syndrome (ARDS), shock, thromboembolic manifestations, multiple organ failure and are at risk of death [1]. One aspect of COVID-19 that puzzles clinicians who must manage pneumonia is that one of the complications of the disease is the presentation of patients with very low blood saturation but no sensation of dyspnea. Roca et al described the discrepancy between pre-hospital initial respiratory rate (IRR) and initial oxygen saturation (SpO2) (i.e., before oxygen supplementation) in COVID-19 patients. They found that some patients had a normal respiratory rate with very low saturation. Awake patients who are very ill with COVID-19 require in some re-

Bepouka et al DOI

Materials & Methods

Operational Definition

Statistical Analyses

Ethical Considerations

General Characteristics

Outcome of Patients with Happy Hypoxia

Discussion

Limitations

Conclusion